Published by
Stanford Medicine

Category

Events

Events, Immunology, Infectious Disease, Microbiology, Public Health

A look at our disappearing microbes

A look at our disappearing microbes

8146322408_5312e9deb2_zCould obesity, asthma, allergies, diabetes, and certain forms of cancer all share a common epidemiological origin? NYU microbiologist Martin Blaser, MD, thinks so – he calls these “modern plagues” and traces them to a diminished microbial presence in our bodies, caused by the overuse of antibiotics and the increased incidence of caesarian sections.

I attended a recent public lecture sponsored by UC Santa Cruz’s Microbiology and Environmental Toxicology department, during which the charismatic Blaser cited statistics about antibiotic use in childhood. Alarmingly, American children receive on average seventeen courses of antibiotics before they are twenty years old, taking a progressively bigger toll on their internal microbial ecosystems. We also have an unprecedented rate of c-sections – at nearly 33 percent. Babies delivered this way are deprived of contact with their mothers’ vaginal microbes, which in vaginal deliveries initiates the infant’s intestinal, respiratory, and skin flora. Breastfeeding has implications for beneficial bacterial transfer, too.

It’s not news that antibiotics are being overused – Stanford Medicine hosts an Antimicrobial Stewardship Program dedicated to this cause, and the CDC has been hosting a campaign for awareness about appropriate antibiotic use for several years, including their use in farm animals. (Seventy to eighty percent of antibiotic use takes place on farms to promote growth – that is, not for veterinary reasons.)

Overuse leads to antibiotic resistance, a serious problem. Meanwhile, research by Blaser and others – notably Stanford microbiologist David Relman, MD – has shown that abundant bacterial and viral life is essential to healthy bodies, and that imbalances in the microbial ecosystems that inhabit our gut play an important role in the chronic diseases of the modern age. Blaser said he is concerned that we’re going down a path where each generation has fewer and fewer species of microbes; part of his research is to compare human gut biodiversity in different parts of the globe, and people in remote areas of New Guinea have far more variety than those in Western nations.

Continue Reading »

Events, In the News, Medical Education, Medicine and Society

Intel’s Rosalind Hudnell kicks off Dean’s Lecture Series on diversity

Intel's Rosalind Hudnell kicks off Dean's Lecture Series on diversity

STANFORD, CA - JANUARY 23, 2015--Rosalind Hudnell ? Chief Diversity Officer, Global Director of Education and External Relations at Intel Corporation, gives a speech on the Fresh Perspectives on Diversity at Dean?s Lecture Series on Friday, January 23, 2015, at Stanford School of Medicine at Berg Hall. ( Norbert von der Groeben/ Stanford School of Medicine )

In 1971, just three years after the death of Martin Luther King, Jr., ninth-grader Lloyd B. Minor was bussed from his white Little Rock, Arkansas neighborhood to a formerly black school. What he saw there stuck in his memory: Plaster peeled off the walls, and the library had only a few tattered books.

“What I had been told was separate but equal was certainly separate, but in no way was it equal,” Minor said. “That caused me then to see that diversity is a moral imperative.”

Now, as dean of Stanford’s School of Medicine, Minor, MD, has made diversity the initial focus of the newly launched Dean’s Lecture Series.

“Diversity is at the core of everything we do,” Minor said at the inaugural lecture last Friday. “To be a highly performing organization, we have to embrace diversity because… creativity doesn’t come from a monolithic, stereotypic focus.”

The featured speaker at the first lecture was Rosalind Hudnell, chief diversity officer and global director of education and external relations at Intel.

“I’m so jealous of the representation of women and people of color in medicine,” Hudnell told the audience. Nearly every child wants, maybe just for a moment, to be a doctor, inspired by the respect the profession commands in society and its portrayal on popular television shows from Marcus Welby, M.D. to Grey’s Anatomy, she said. By contrast, about 40 percent of college students drop out of engineering after the first year.

In 2013, Intel’s approximately 100,000 employees were 76 percent male and 86 percent white or Asian, and Hudnell said Intel has been working hard to diversify its workforce. The company recently captured headlines by pledging $300 million over three years to recruit and retain more minorities and women.

“We’ve spent the last decade building capability,” Hudnell explained. “Then, we stepped back and said, ‘So, why aren’t we better?’”

The key is to set goals and hold everyone accountable, she said. Now, Intel is committed to reaching market representation across its workforce by 2020. Hudnell admitted she isn’t quite sure how that’s going to happen, but she’s confident it will. “It’s time to use our capability and lead.”

And in that regard, she believes Stanford’s School of Medicine has an advantage. “I think, quite frankly, you are incredibly blessed and lucky to have a leader who truly gets it,” Hudnell commented. “It really does take a consistent, resilient leader… They must have a personal belief in their soul and in their DNA that diversity is the ultimate goal.”

Continue Reading »

Events, Medical Education, Medical Schools, Stanford News, Videos

What’s it like to be an internal medicine resident at Stanford?

What's it like to be an internal medicine resident at Stanford?

“I remember being in your shoes,” Ronald Witteles, MD, said to prospective residents during a recent Google+ Hangout sponsored by the Stanford Internal Medicine Residency program. “I really felt that Stanford was the best fit for me, so I crossed my fingers and came out here. It’s been everything I hoped it could be and more.”

Witteles is the resident program director, and he joined a panel of faculty, residents, and physicians to share stories and answer questions from prospective residents and the interested public about life at Stanford.

During the Hangout, department chair Robert Harrington, MD, spent time discussing Stanford’s tradition of innovation – highlighting the Biodesign program, a collaboration between the School of Medicine and the School of Engineering, and the Department of Medicine’s Clinical Excellence Research Center, which organizes research teams to discover and design new methods of health-care delivery. When asked to comment on the school’s innovative reputation, he replied: “There is a spirit of innovation across the residency, across the department, and across the university that I think is unique, and is one of our defining characteristics.”

Several programmatic changes were also addressed during the hour-long conversation. Witteles talked about a new initiative called Pathways of Distinction, or POD, which will allow residents to select one of seven individualized pathways that align with their academic and professional interests. Each POD, he explained, will provide residents with a unique opportunity for mentorship and development outside of their primary education in internal medicine.

Additional audience questions ranged from the level of autonomy afforded to residents (the answer: a significant amount, but you’re never left by yourself), to favorite things about Palo Alto, which garnered enthusiastic group consensus about the vibrant food scene and the close proximity to nature. Watch the full conversation above.

Previously: Stanford Internal Medicine Residency program to host Google+ Hangout

Events, Science

Nobel laureate Randy Schekman on the importance of scientists clearly communicating about their work

Nobel laureate Randy Schekman on the importance of scientists clearly communicating about their work

colorful brains - 560

I consider myself a professional nerd (my background is in chemistry and neuroscience) and have attended many academic talks during my life. I’ll be honest: I’ve spaced out during quite a few talks that were outside of my area of expertise.

Earlier this week, I attended a talk on campus by 2013 Nobel laureate and Stanford alumnus Randy Schekman, PhD. The subject of his talk – how cells expel a special kind of vesicle – was way out of my comfort zone. (I’m more neuroscientist than chemist.) But Schekman didn’t lose me as an audience member.

After Schekman finished speaking about his research, he was asked to comment about the role of teaching in his life. His answer, during which he explained that one of his responsibilities at UC Berkeley is to teach is an undergraduate seminar, explains my engagement during his talk.

“I’ve learned when you teach undergraduates – people who are smart but uninitiated – you have to make yourself understood,” Schekman said.

It is obviously this effort, this desire to succeed at communicating the complexities of what happens in his lab and his field to undergraduates and experts alike, that makes Schekman an accessible speaker.

And Schekman made clear that making yourself understood has benefits beyond connecting with your audience. As he told the audience, every now and then he teaches an outstanding student who challenges him, forcing him to think more deeply about subjects he thought he knew well.

Schekman spoke at the Medical Grand Rounds and was this year’s Rubenstein lecturer. Founded by friends of Edward Rubenstein, MD, the lectureship was created to honor Rubenstein’s commitment to the intersection of education with the clinical sciences.

Kimberlee D’Ardenne is a writing intern in the medical school’s Office of Communication and Public Affairs.

Previously: Hawkeye Pierce (i.e. Alan Alda) teaches scientists how to better communicate about their work, A call to fix the “crisis of communication” in science, Stanford’s Thomas Südhof wins 2013 Nobel Prize in Medicine and Challenging scientists to better communicate their ideas to the public
Photo by Joan M. Mas

Cancer, Complementary Medicine, Events, Patient Care

Knitting needles cancer while helping patients

148228001_9e84d0bbc7_z

It may sound unusual, but knitting is one way to cope with difficult experiences, such as undergoing cancer treatment. Rhythmic and relaxing, knitting can sooth the mind and soak up the downtime that’s a big part of cancer treatment, according to Holly Gautier, RN, a nurse and director of the Cancer Supportive Care Program at Stanford.

“It’s the repetitive motion that you have with knitting… You’re focused on the stitching and your mind becomes somewhat blank – it really feels good to be making something new,” Gautier explained to me recently.

Although she administers a slew of programs – from yoga to art – Gautier said she’s particularly excited about a new knitting class, which meets weekly at the Stanford Cancer Center.  It’s free and open to all cancer patients and their families — not just those being treated at Stanford.

The class is led by a volunteer knitters, who provide supplies and teach the basic stitches. They can even accompany patients to treatment rooms to answer questions or undo an error, Gautier said. And they’re happy to put together “knitting-to-go” care packages for those who can’t stay.

While participants are welcome to work on other projects, such as scarves and hats, the class is currently making squares to create a quilt to raffle off at an upcoming benefit for the Cancer Survivorship Program. Gautier said the quilt project provides patients with an opportunity to give back – something that nearly all patients yearn to do.

Although the first session last Tuesday drew eight female patient-knitters, Gautier said she hopes other patients and caregivers, particularly men, stop by in coming weeks. More details on the Knitting with Friends program can be found here.

Previously: Knitting as ritual — with potential health benefits?, Image of the Week: Personalized brain activity scarves and A look at how helping others can be healing
Photo by meknits

Events, Pain, Stanford News

Advances in diagnosing and treating a painful and common jaw disorder

Advances in diagnosing and treating a painful and common jaw disorder

3439490784_46b2cfd9e3_zOn New Years Eve, Australian rapper Iggy Azalea shared with her Twitter followers that she was diagnosed with a temporomandibular joint dysfunction (often referred to as TMD or TMJ). The singer is among the estimated 10 million Americans who suffer from the condition, which is more common in women than men and people ages 20 to 40.

Symptoms of the disorder include a stiffness of jaw muscles, limited movement, clicking or locking of the jaw and radiating facial pain. It was previously believed that problems with how the teeth fit together or the structure of the jaw caused the condition. But in talking to Michele Jehenson, DDS, a clinical assistant professor at the Pain Management Center at Stanford, I was told, “There is still a lot we do not know about what causes [temporomandibular joint dysfunction] but one thing we do know is that they are not caused by upper and lower teeth misalignment or improper jaw position. We now believe that TMD susceptibility is, at least, partly genetic.”

Since the causes of the TMD are not clear, diagnosing the condition can be challenging. Currently, there is no standardize test for providers to use to diagnose patients, so physicians continue to rely on the clinical evaluation, including palpation, range of motion and auscultation. But imaging technologies are starting to play a more important role. Jehenson noted, “We now have more accurate imaging such as cone beam CT scans or MRIs. Some dentists use joint vibration analysis or EMG, but these electronic sensors have been shown to be unreliable and lead to over diagnosis.”

Over the past two decades, there as been a significant amount of research on the outcomes of TMD treatments. As Jehenson told me:

Evidence is very clear that aggressive and non-reversible treatments for TMD (braces, jaw surgery, crowns, full time wear of appliance, jaw repositioning) are rarely indicated. The best treatments should be conservative. Depending on the case, treatments are usually a mix of medication (oral or topical), nighttime appliance wear, injections, physical therapies, behavior modification and counseling, sleep and stress management.

To learn more about the diagnosis and treatment of TMD, join Jehenson for a Stanford Health Library talk on Thursday at 7 PM Pacific Time. During the event, she’ll l further discuss evidence based versus non-evidence based treatments. Those unable to attend in person can watch the talk online.

Photo by Eric Allix Rogers

Events, In the News, Public Safety, Stanford News

Stanford biomedical community shows support for those affected by police violence

Stanford biomedical community shows support for those affected by police violence

group on ground - 560

Scores of biomedical students, researchers, faculty and staff  staged a “die-in” yesterday to protest excessive police violence against people of color.

Clad in black “BlackLivesMatter” t-shirts, demonstrators lay down on the medical school’s Discovery Walk while listening to Martin Luther King, Jr.’s “I Have a Dream” speech. The demonstration was organized by the Biomedical Association for the Interest of Minority Students (BioAIMS.)

The demonstration also featured two large posters that prompted viewers to complete the statement “I am privileged because…” or “I have a dream…”

Organizers said they were motivated to stage the demonstration because they felt there wasn’t enough conversation about the issue on the Stanford campus.

The Stanford community is comprised of people with a variety of backgrounds, who come from all sorts of communities, organizer and graduate student Jesus Madrid said. “Do we want to forget what it’s like outside?”

The demonstrators pointed out that violence against minorities is very relevant to biomedical researchers and doctors. “People getting killed is absolutely medically relevant,” said graduate student and organizer Tawaun Lucas.

In addition, it takes widespread societal awareness that extends beyond racial groups to promote change, the organizers said.

BioAIMS president Julie Huang said the group was pleased with the turnout, which topped 150 people.

A few voices from the demonstration:

“On a campus like this, we do need to focus on issues that are globally important.”
Sheri Krams, PhD, associate professor of surgery

“I’m new here, and I wanted to inform myself. In Austria, we absolutely have police violence against minorities.”
—Alex Woglar, PhD, postdoctoral research fellow in developmental biology

“It could have been any of us.”
—Tawaun Lucas, graduate student and member of BioAIMS

BioAIMS intends to keep the dialogue ongoing by hosting a series of upcoming events, including “Transitions into Privilege,” a forum scheduled for Thursday, Jan. 22 from 12-1 PM in the fourth floor reading room at the Li Ka Shing Center for Learning and Knowledge.

Previously: Community violence can increase risk of heart disease, What happens when people witness violence and death? and Gun safety addressed by editorials in three JAMA journals
Photo by David Purger

Ebola, Events, Infectious Disease, Stanford News

Physician at forefront of Ebola fight: “Ultimate award” is what you get back from survivors

Physician at forefront of Ebola fight: "Ultimate award" is what you get back from survivors

BauschWhen Lassa fever, a cousin of Ebola, was afflicting hundreds of thousands of people in West Africa in the late 90s, Daniel Bausch, MD, MPH & TM, worked with the federal Centers for Disease Control and Prevention in Guinea to set up a laboratory for study and testing of the rodent-borne disease. Unfortunately, the lab lost its international funding in 2003, as it could have proven useful in preventing the Ebola epidemic, which began in a remote village in Guinea just a few hours away, Bausch told a Stanford audience last week.

“I think back that if we had succeeded in keeping this lab going, how different it would have been if we’d been able to just send a sample down the road,” instead of losing valuable time in shipping the samples to Europe for testing, said Bausch, the keynote speaker at a day-long global health conference.

Today, Bausch, an associate professor at the Tulane School of Public Health and Tropical Medicine, is at the forefront of the Ebola fight, treating patients at an Ebola clinic in Sierra Leone that he helped establish and training and recruiting other clinicians. He is also consulting with the World Health Organization in the development and implementation of treatment guidelines and drug and vaccine testing for the disease.

In 1996, Bausch was working with the CDC in the Democratic Republic of Congo, where dozens of miners were being felled by a strange set of symptoms. The source was identified as Marburg virus, a cousin of Ebola that kills more than 80 percent of victims. While the usual course of spread is from one person to the next, these miners were harboring different variants of the virus, suggesting multiple sources, he said. The disease was traced back to the caves where miners unearthed their gold and where they were exposed to bats — the likely reservoir of the virus, Bausch said. He and colleagues published an article on their Marburg investigation in 2006 in the New England Journal of Medicine.

Because of his rare expertise with hemorrhagic fevers, Bausch was called upon early on to help fight in the latest Ebola outbreak, working alongside West African colleagues in Guinea and Sierra Leone who died of the disease.  He said one bright spot in the epidemic is the speed with which scientists have moved forward in developing new treatments and potential vaccines. “In the last six months, we’ve seen a process that’s unprecedented, with accelerated science and the launch of clinical trials that would normally take years,” he said.

And he said he cherishes the experience of seeing patients who have successfully fought off the disease. He showed a photo of a colleague, draped in white protective gear, alongside a young survivor: a smiling boy in striped pants who had lost his father to Ebola.

“That is the ultimate reward… It means something to you – what you get back from (the survivors),” he said.

The Stanford Global Health Research Convening Day was sponsored by Stanford’s Center for Innovation in Global Health.

Previously: Back home from Liberia, Stanford physician continues to help in fight against EbolaEbola: This outbreak is differentStanford physician shares his story of treating Ebola patients in Liberia and Ebola: A look at what happened and what can be done
Photo, of Daniel Bausch and others in Guinea, courtesy of Bausch

Events, Medical Education, Medical Schools, Stanford News

Stanford Internal Medicine Residency program to host Google+ Hangout

Stanford Internal Medicine Residency program to host Google+ Hangout

Are you interested in internal medicine? Or wondering what doing a Stanford residency is like? Then join Stanford’s Internal Medicine Residency program tomorrow for a Google+ Hangout, where program leadership will talk about the current landscape of internal medicine, share program highlights and answer your questions.

During the discussion, you’ll meet faculty and physicians who are transforming the field of internal medicine. You’ll also hear from current and former residents who will reflect on their experiences at Stanford. Ronald Witteles, MD, assistant professor and director of Stanford’s residency program, will moderate the conversation. Other panelists include:

  • Robert Harrington, MD, chair of the department of medicine
  • Abraham Verghese, MD, physician and vice chair of education
  • Neera Ahuja, MD, associate professor and associate director of Stanford’s residency program
  • Wendy Caceres, MD, clinical instructor and former resident
  • Jim Boonyaratanakornkit, MD, chief resident
  • Kathryn Weaver, current resident

The discussion begins at 1:30 PM Pacific Time. Visit this page to participate in the hangout.

Lindsey Baker is the communications manager for Stanford’s Department of Medicine.

Events, Medical Education, Medicine and Society, Stanford News

Diversity is initial focus of new Stanford lecture series

Diversity is initial focus of new Stanford lecture series

directory-281478_640How often does a psychiatrist stop to chat with a bioengineer? Or a first-year medical student with an established postdoc? At Stanford, more often than you might think, yet there’s always room for improvement, building community and promoting dialogue.

Hence the Dean’s Lecture Series, a new series launched by none other than the dean himself, Lloyd B. Minor, MD.

Initially, the series will focus on diversity, kicking off Jan. 23 with a presentation by Rosalind Hudnell, the chief diversity officer and global director of education and external relations at Intel Corporation. (Her talk is timely, given Intel’s announcement yesterday that they’re allocating $300 million “to improve the diversity of the company’s work force, attract more women and minorities to the technology field and make the industry more hospitable to them once they get there.”)

Minor said he launched the lecture series to unite students, faculty and staff and to spark dialogue on issues of importance. As for the first topic: “We all benefit from the transformative power of diversity,” he said. “It is an integral part of what it means to lead the biomedical revolution and a core value of the Stanford Medicine community.”

Following Hudnell’s inaugural talk, Vivek Wadhwa, MBA, a fellow at the Center for Corporate Governance at Stanford, will speak on Feb. 20, and Ruth Simmons, PhD, president emerita of Brown University, will speak on May 1. All lectures will be held from 12 to 1 p.m. in Berg Hall at the Li Ka Shing Center for Learning and Knowledge on campus.

I’ll be there. How ’bout you?

Previously: NIH selects Hannah Valantine as first chief officer for scientific workforce diversity, Report explores student diversity in medical schools and Lloyd B. Minor, Stanford medical school’s dean, shares five principles of leadership
Photo by geralt

Stanford Medicine Resources: